Individual
TIJUANA LISETTE FREEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3650 GROVELAND RD, OCEAN SPRINGS, MS 39564-5753
(228) 875-0780
(228) 875-1009
Mailing address
3650 GROVELAND RD, OCEAN SPRINGS, MS 39564-5753
(228) 875-0780
(228) 875-1009
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
15040
MS
208000000X
Pediatrics Physician
E-1828
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1222017
UNITED HEALTH CARE
AR
05
—
135418001
—
AR
01
—
1832000000
QUAL CHOICE
AR
Enumeration date
04/20/2006
Last updated
12/29/2011
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